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December 11, 2024

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In Focus

2025 Outlook: The Landscape for Medicaid Section 1115 Demonstrations

This week, our In Focus section highlights state Medicaid Section 1115 demonstration priorities from the past four years and outlines anticipated changes during a new presidential administration. In the waning days of any presidency, regardless of party, reviewing and approving pending Section 1115 applications that reflect the current administration’s key policy initiatives is a priority for officials at the Centers for Medicare & Medicaid Services (CMS). 

Each administration has discretion over which Section 1115 demonstrations to encourage and approve. Though specific Medicaid priorities under the upcoming Trump Administration are still nascent, Health Management Associates, Inc. (HMA), federal, and state experts are monitoring these developments. This article describes a subset of the signature initiatives the Biden Administration permitted states to pursue in their Medicaid Section 1115 demonstrations and how the new administration could focus on different priorities, rescind existing guidance, or potentially withdraw already approved waivers. 

Overview of Biden-Era Section 1115 Demonstration Initiatives 

CMS-approved Section 1115 demonstrations permit alternative methods to improve the accessibility, coverage, financing, and delivery of healthcare services under joint federal-state funded programs, specifically Medicaid and the Children’s Health Insurance Program (CHIP). 

Addressing health disparities and promoting integrated care in Medicaid became a primary focus of the Biden Administration. In November 2023, CMS introduced a Medicaid and CHIP Health-Related Social Needs (HRSN) Framework, giving state Medicaid agencies the opportunity to address the broader social determinants of health (SDOH) that affect their enrollees, leading to better health outcomes. The new initiatives were not intended to replace other federal, state, and local social service programs, but rather to coordinate with those efforts. HRSN demonstration approvals to date include coverage of rent/temporary housing and utilities for up to six months and nutrition support (up to three meals per day), departing from longstanding prohibitions on payment of room and board in Medicaid. 

During the present administration, CMS also has provided novel opportunities for states to adopt strategies that promote continuity of Medicaid coverage, mainly through bolstering Section 1115 demonstrations to provide multiyear continuous eligibility for children. In addition, CMS released guidance in April 2023 so states could apply for a new Section 1115 demonstration opportunity to test transition-related strategies that support community reentry for incarcerated people who would otherwise be eligible for Medicaid or CHIP. 

The table and map below show the types of demonstrations approved and pending to date. We anticipate that incoming administration officials will closely examine the four demonstration initiatives outlined as they determine their own Medicaid policy agenda and priorities. Under President Biden’s Administration, nine states received federal approval for HRSN demonstrations under the new framework. Another 10 states have applications pending. 

Rescissions and renewals. Incoming Trump Administration officials technically could attempt to rescind some of the Section 1115 demonstrations approved during the Biden Administration. The Biden Administration unsuccessfully pursued with, a similar strategy for certain 1115 demonstration components approved during President-Elect Trump’s first term. Like the Biden Administration, the incoming Trump officials may choose not to renew demonstrations, even if the courts prevent them from rescinding approvals. 

Any signature Section 1115 policy is unlikely to emerge until the new administration’s policy officials are in place. There are, however, important insights to consider based on the first Trump Administration’s priorities and areas of common ground across the Biden and first Trump administrations. 

Signature 1115 initiatives. During President Trump’s first term, one signature Medicaid Section 1115 initiative allowed states to apply work requirements to some eligibility groups. CMS officials at that time also approved capped allotments for certain components of a state’s Medicaid program. Some states might consider revisiting these options with incoming administration officials. Two other key policy areas to watch following the transition include: 

  • The first Trump Administration approved a pilot program to test interventions addressing HRSNs in  North Carolina’s Medicaid 1115 demonstration program. Though the approved HRSNs were less expansive than the HRSN 1115 interventions later announced by the Biden Administration, this could be an area of common ground where the policy evolves and can be incorporated into discussions on other nascent initiatives. 
  • Multiple administrations, including the first Trump Administration, have prioritized Medicaid policies and demonstration initiatives to address substance use disorders (SUD) and, separately, reentry. The intersection of these issues can provide another area of common ground and opportunity to continue work on state reentry initiatives, though likely with new and modified parameters. 

Implementation Considerations 

Federal approval of Medicaid Section 1115 demonstration proposals is a critical milestone for states. Demonstration implementation also requires significant and ongoing leadership, resources, and collaboration between states and CMS and states and their partners. 

The type of state demonstration activity is expected to shift dramatically over the course of the new administration. For example, proposals may shift from expansions in coverage and benefits to reflect the new administration’s other priorities. States, too, may consider alternative approaches to Section 1115 demonstrations, such as state plan authorities like in lieu of services (ILOS), to pursue certain innovative approaches that they might otherwise have implemented with demonstration authority. 

Connect with Us 

HMA empowers states, providers, and other stakeholders to thrive in an ever-changing healthcare landscape. With deep expertise at every level, HMA teams support state Medicaid programs and stakeholder partners nationally to address a range of operational challenges, including designing innovative healthcare approaches to address urgent healthcare challenges, expanding coverage opportunities, and optimizing integration to address program efficiencies and improved “whole person” care.  

We have expertise in all of the components critical to developing Section 1115 programs—from the policy knowledge, to actuarial/budgeting talent, to communications and project management skills, as well as the necessary IT infrastructure. 

Contact Kathy Gifford, Tonya Moore, and Matt Powers to learn more about HMA’s capabilities and expertise. 

HMA Roundup

Colorado

Colorado Medicaid Program to Cover Undocumented Children, Pregnant Women Starting January 1. CBS News reported on December 6, 2024, that a new Colorado Medicaid program, called Cover All Coloradans, will begin to cover prenatal and postpartum care for eligible pregnant women, and physical, dental, vision, and mental health care for eligible children, regardless of immigration status beginning January 1, 2025. Colorado now joins approximately a dozen states covering Medicaid for undocumented immigrants. The state estimates the program will cover 15,049 people in 2025 and cost $51 million.

Florida

Florida Receives Federal Approval for KidCare Expansion, Delays Implementation Over Continuous Eligibility Requirements. Health News Florida reported on December 6, 2024, that Florida has received federal approval from the Centers for Medicare & Medicaid Services (CMS) for its Section 1115 Children’s Health Insurance Program (CHIP) Eligibility Extension demonstration, which expands eligibility for KidCare, the state’s CHIP program, for children whose parents earn up to 300 percent of the federal poverty level. However, the state rejected the expansion due to a CMS requirement to provide 12 months of continuous coverage, and is planning to request a 30-day delay on the demonstration to allow for the incoming Trump administration to review the policies. Florida previously filed a lawsuit over the mandate, and then filed an appeal after the initial lawsuit was dismissed.

Georgia

Georgia Extends Protest Filing Deadline for Medicaid Managed Care Procurement. The Georgia Department of Community Health (DCH) announced on December 9, 2024, a notice of the decision to extend the protest filing deadline for the Georgia Families and Families 360° program procurement to December 17. The state has attributed the extension to a delay in the release of procurement documents.

Idaho

Idaho Requests Additional $108 Million for Medicaid Behavioral Budget. The Idaho Capital Sun reported on December 11, 2024, that the state Department of Health and Welfare (DHW) is requesting $108 million to supplement the Idaho Behavioral Health Plan (IBHP) budget, citing higher-than-expected utilization of behavioral health services for the request. Most of the additional funds would help pay the current IBHP contractor, Magellan of Idaho, and a portion of the funds would go to the previous IBHP contractor, United/Optum. The current four-year IBHP contract, which began July 1, 2024, is valued at $1.2 billion.

Kentucky

Kentucky Representative Pre-files Legislation to Form Medicaid Oversight, Advisory Board. WHOP reported on December 4, 2024, that Kentucky Representative Jason Petrie (R-Elkton) has pre-filed legislation to establish a Medicaid oversight and advisory board that the Kentucky General Assembly will consider in its 2025 short session. The board, which would be comprised of 12 legislators and 14 non-legislative members, would review, analyze, and evaluate program data to make policy recommendations. The bill was discussed at a meeting of the Interim Joint Committee on Appropriations and Revenue.

Massachusetts

Massachusetts Receives Federal Approval for 1115 MassHealth Demonstration Amendment for Pre-release Services. The Centers for Medicare & Medicaid Services (CMS) announced on December 9, 2024, that it approved Massachusetts’ section 1115 MassHealth demonstration amendment, effective through December 31, 2027. The amendment allows for coverage of pre-release services, including certain screening, diagnostic, and targeted case management, for eligible incarcerated juveniles and targeted low-income children in the 30 days prior to release.

Massachusetts Forms MassHealth Program Advisory Committee. The Massachusetts Executive Office of Health and Human Services announced on December 10, 2024, the formation of its MassHealth Program Advisory Committee (MPAC), which aims to provide advice to MassHealth on policy development and program implementation to improve quality and access to care for Medicaid beneficiaries. MassHealth is seeking approximately twelve individuals to join the MPAC, including MassHealth-serving stakeholders and representatives from other state agencies that serve Medicaid members.

Michigan

Michigan Updates Regional Assignments for HIDE D-SNP Awards. The Michigan Department of Health and Humans Services (MDHHS) announced on December 6, 2024, that it has re-awarded $6.9 billion contracts to the same nine health plans for the MI Coordinated Health program, the state’s new Highly Integrated Dual Eligible Special Needs Plan (HIDE SNP), with updated regional assignments. Awarded plans include incumbents CVS/Aetna, AmeriHealth Caritas, HAP/CareSource, Centene/Meridian Health Plan, Molina, and Upper Peninsula Health Plan, and non-incumbents: Humana, Priority Health Choice, UnitedHealthcare. Plans with updated regional assignments include Molina, Upper Peninsula Health Plan, Humana, Priority Health Choice, AmeriHealth Caritas, and HAP/CareSource. Zing Health did not receive an award. The contracts, which will serve 35,000 dual eligibles, will run for seven-years and include three, one-year optional extensions. Implementation begins January 1, 2026.

Minnesota

Minnesota DHS Failed to Recover $40 Million in Medicaid Provider Overpayments, Audit Finds. CBS News reported on December 10, 2024, that the Minnesota Department of Human Services (DHS) did not comply with legal requirements in recovering more than $40 million in overpayments to Medicaid providers between October 2006 and June 2023, according to a report by the Office of the Legislative Auditor’s Financial Audit Division. The audit’s findings showed the department was planning to forgo recovery of outstanding provider debt which still may be recoverable.

Montana

Montana Receives Federal Approval for 1115 Montana HEART Demonstration Amendment. The Centers for Medicare & Medicaid Services (CMS) announced on December 9, 2024, that Montana has received federal approval for an amendment to its section 1115 Montana Healing and Ending Addiction through Recovery and Treatment (HEART) demonstration through June 30, 2027. The amendment allows for coverage of pre-release services, including certain screening, diagnostic, and targeted case management, for eligible incarcerated juveniles and targeted low-income children in the 30 days prior to release.

Nevada

Nevada Submits Treatment of OUD, SUD Transformation Project Demonstration Amendment. The Centers for Medicare & Medicaid Services announced on December 11, 2024, that Nevada has submitted an amendment to its Section 1115 Treatment of Opioid Use Disorders (OUD) and Substance Use Disorders (SUD) Transformation Project demonstration. The amendment seeks to cover SUD treatment when provided in an Institution for Mental Disease and coverage for services that address certain health-related social needs, including stable housing and nutrition supports. The public comment period will be open through January 9, 2025.

North Carolina

North Carolina Receives Federal Approval for Medicaid Reform Demonstration Amendment. The Centers for Medicare & Medicaid Services announced on December 11, 2024, that it has approved a five-year extension of North Carolina’s section 1115 Medicaid Reform demonstration. The extension provides authority for seven new initiatives, including for continuous eligibility for children up to age six; coverage for foster care youth who turned 18 years old from other states; enhanced home and community-based benefit; health information technology incentive-based programs; workforce initiatives; designated state health programs; and the reentry demonstration initiative.

Ohio

Ohio Releases EQRO RFP. The Ohio Department of Medicaid (ODM) released on December 10, 2024, a request for proposals (RFP) seeking one qualified external quality review organization (EQRO) for Ohio’s Medicaid program. The EQRO will ensure ODM complies with federal regulations, it will assess the quality, timeliness, and accessibility of services available through managed care entities, and it will provide technical assistance and other expertise to support and improve Medicaid delivery. Proposals are due January 22, 2025. ODM estimates that awards will be announced in March 2025, and contracts will run from the awarded date through June 30, 2027, with the possibility of two two-year contract renewals. The current incumbent is IPRO.

Oregon

Oregon Medicaid Agency to Pursue Policy, Regulatory, Administrative Changes. The Oregon Health Authority (OHA) released on December 10, 2024, a listening tour report outlining various regulatory, administrative, and policy changes that OHA plans to pursue to help boost transparency, accountability, and community support across the state. Some of the changes highlighted in the report include reducing administrative burdens on mental health and substance use programs, supporting traditional health workers and doulas to bill Medicaid for services, scaling Medicaid reimbursement to distribute medications for people living on the streets, and preventing health care facility closures in rural communities. OHA leaders will hold follow up sessions across the state to track progress and address additional concerns.

Virginia

Virginia Medicaid NEMT RFP Proposals Due January 2025. The Virginia Department of Medical Assistance Services (DMAS) announced that proposals for its non-emergency medical transport (NEMT) brokerage services request for proposals (RFP) are due January 10, 2025. DMAS is seeking proposals that reflect the technological developments of the NEMT industry, including utilization of interactive voice responsive systems, interactive administrative dashboards and reporting databases, computer assisted dispatching software systems, and artificial intelligence and computer learning integrated systems. The RFP was released on November 7, 2024. The new contract will run for five years, with two possible renewals of up to 24 months each. The incumbent broker is ModivCare, formerly called LogistiCare.

Washington

Washington Receives Federal Approval for Community Health Worker SPA. The Washington Health Care Authority announced on December 11, 2024, that the Centers for Medicare & Medicaid Services (CMS) has approved its state plan amendment (SPA) allowing community health workers (CHWs) to provide preventive services to Apple Health enrollees beginning January 1, 2025. HCA is drafting rules to outline details of the benefit, including CHW requirements, eligibility requirements, and covered and non-covered services. The agency plans to release the draft rules for public comment by the end of 2024.

National

CMS Releases 2024 Medicaid, CHIP MAC Scorecard. The Centers for Medicare & Medicaid Services (CMS) released on December 11, 2024, its 2024 Medicaid and Children’s Health Insurance Plan (CHIP) (MAC) Scorecard. The MAC Scorecard highlights program characteristics such as care delivery, the use of data to support program improvement, eligibility and enrollment, and expenditures; health care quality performance; and program administration with the intent to improve transparency and accountability for the Medicaid and CHIP programs. This year’s version includes a new feature that allows users to focus on the data of one, two, or three states or territories at a time. The Scorecard pulls from 30 datasets derived from state and federal reporting efforts.

CMS Releases Updated Informational Bulletin for HRSN Coverage Opportunities. The Centers for Medicare & Medicaid Services (CMS) released on December 10, 2024, an updated informational bulletin outlining opportunities available under Medicaid and the Children’s Health Insurance Program to provide coverage for clinically appropriate and evidence-based services and supports that address health-related social needs (HRSN). States can address HRSN through coverage of clinically appropriate and evidence-based HRSN services and supports; care delivery transformations, including improvements in data sharing; and performance measurement to create accountability for HRSN screening and connecting to needed supports as part of successful care management.

Federal Judge Blocks DACA Recipients from ACA Marketplace Coverage. The Hill reported on December 9, 2024, that a federal judge in North Dakota ruled to block Deferred Action for Childhood Arrivals (DACA) recipients from enrolling in health plans available through the Affordable Care Act (ACA) Marketplace. The Centers for Medicare & Medicaid Services (CMS) released a final rule in May 2024 allowing active DACA recipients to enroll in ACA coverage; however, the agency faced lawsuits from several states who argued the rule violates the Administrative Procedure Act and the ACA. The judge granted a stay against CMS and barred the agency from enforcing the final rule, citing that DACA recipients are not considered “lawfully present” as per prior CMS rules.

Congressional Democrats Propose Extension of ACA Expanded Tax Credits Through 2026. Health Payer Specialist reported on December 9, 2024, that Democratic lawmakers have proposed a plan in Congress to extend expanded Affordable Care Act (ACA) subsidies through 2026. The extension was proposed as a part of legislative packages for funding the federal government. The current expanded subsidies expire at the end of 2025, and the Congressional Budget Office estimates that without an extension, 2.2 million Marketplace enrollees could lose coverage by 2026, with the total rising to 3.7 million by 2027.

CMS Lacks Controls Preventing Unauthorized Federal Payments of Non-Essential Health Benefits, GAO Finds. Financial Regulation News reported on December 6, 2024, that the Centers for Medicare & Medicaid Services (CMS) is not adequately enforcing an Affordable Care Act rule requiring states to fund state-mandated health insurance benefits for plans operating in the federal Marketplace, according to a report released by the Government Accountability Office (GAO). The report highlights that CMS delegates the oversight to the states, which is inconsistent with federal internal control standards. GAO recommends CMS conduct a risk assessment of its oversight approach to determine its efficiency, ensuring that advance premium tax credits exclude the costs of mandated non-essential health benefits. The U.S. Department of Health and Human Services agreed with the recommendation.

Hospitals Sue HHS Over Medicare IPPS Reimbursement Rates. Modern Healthcare reported on December 5, 2024, that more than 500 hospitals sued the U.S. Health and Human Services Department (HHS) over allegedly miscalculating an Inpatient Prospective Payment System (IPPS) base reimbursement rate which providers claim has lowered years of subsequent Medicare payments to hospitals. The hospitals claim that the HHS Provider Reimbursement Review Board wrongfully dismissed appeals dating back to 2002 based on the payment system’s budget neutrality framework. The hospitals are requesting the federal government change the inpatient base pay rate which would allow hospitals to recoup money from prior fiscal years and increase future reimbursement rates.

Senators Introduce Bill to Expand Direct Primary Care Arrangements in Medicaid. Tech Target reported on December 6, 2024, that Senator Marsha Blackburn (R-TN) and Senator Mark Kelly (D-AZ) introduced a bill which aims to expand state opportunities to engage in direct primary care arrangements for Medicaid beneficiaries. The Medicaid Primary Care Improvement Act would address disproportionate health care access in rural areas by providing states with greater flexibility to address primary care challenges within Medicaid populations. The bill passed the House earlier this year and is now pending in the Senate.

Medicare Spending 27 Percent Higher on Medicare Beneficiaries Who Disenrolled from Medicare Advantage, KFF Finds. KFF released on December 6, 2024, an issue brief highlighting the per person Medicare spending of individuals previously enrolled in Medicare Advantage (MA) that disenrolled and switched to traditional Medicare. The issue brief found that on average, Medicare spent 27 percent, or $2,585 per person, more on this population than it spent on similar people continuously enrolled in traditional Medicare. It also highlighted how the differences in Medicare spending between former MA enrollees and similar people who were continuously enrolled in traditional Medicare increased based on certain demographic categories, including higher spending on individuals with certain health conditions, older Medicare beneficiaries, and Black and Hispanic Medicare beneficiaries. Additionally, Medicare spent 61 percent more on dual eligibles with full Medicaid benefits that disenrolled from MA compared to their counterparts who were continuously enrolled in traditional Medicare.

Majority of Americans Identify Cost as Top Healthcare Concern, Poll Finds. Modern Healthcare reported on December 6, 2024, that nearly 80 percent of Americans are dissatisfied with the cost of healthcare, according to Gallup’s annual Health and Healthcare poll conducted between November 6, 2024, and November 20, 2024. Respondents claimed the most urgent health problem facing the country was cost, followed by access and obesity. National health expenditures from consumers are expected to rise to $7.7 trillion by 2032, increasing by an average of 5.6 percent per year, according to the Centers for Medicare & Medicaid Services Office of the Actuary.

MACPAC Meeting Is Scheduled for December 12-13. The Medicaid and CHIP Payment and Access Commission (MACPAC) announced on December 6, 2024, that its next meeting will be held on December 12 and 13. The meeting will feature a special panel discussion on self-direction in home and community-based services (HCBS) to discuss key topics such as self-directed services and policies affecting developmental disabilities. Other discussion topics include tools for accountability in Medicaid managed care; draft recommendations on external quality review; policy options for transitions of care for children and youth with special health care needs; and and spending and utilization in HCBS.

More Than 500 Hospitals Stopped Offering Obstetric Services, JAMA Study Finds. The New York Times reported on December 4, 2024, that more than 500 hospitals closed their labor and delivery departments between 2010 and 2022, and 130 hospitals opened new units, according to a study published in the online journal JAMA. The study found that urban hospitals had the highest number of labor and delivery unit closures, totaling 299, however a large share of rural hospitals do not offer maternity care. The closures have coincided with growing maternal and infant mortality and increased care access barriers for rural residents and racially minoritized individuals.

Industry News

PACS Group Acquires 11 Skilled Nursing Facilities in Tennessee. Modern Healthcare reported on December 6, 2024, that Utah-based long-term care company PACS Group has acquired the operations of 11 Tennessee skilled nursing facilities, with an acquisition for a 12th Tennessee facility expected to close in the first quarter of 2025. The facilities will be leased from an affiliate of CareTrust REIT. PACS Group did not disclose the names of the facilities or the financial terms of the deal. The transaction brings PACS Group’s total operations to 314 post-acute care facilities and senior living communities across 17 states.

Supreme Court Rejects PhRMA Appeal Against 340B Drug Law in Arkansas. Reuters reported on December 9, 2024, that the U.S. Supreme Court declined to hear an appeal by Pharmaceutical Research and Manufacturers of America (PhRMA) against Arkansas’ 340B drug pricing law. The law requires pharmaceutical companies to offer discounts on drugs dispensed by third-party pharmacies that contract with hospitals and clinics serving low-income populations. PhRMA argued that the law conflicts with federal rules governing drug distribution. The Supreme Court did not give any reason for declining to take the case.

Bristol Myers Squibb Files Lawsuit Over 340B Rebate Model. Fierce Healthcare reported on December 3, 2024, that Bristol Myers Squibb has filed a lawsuit against The U.S. Department of Health and Human Services (HHS) and the Health Resources and Service Administration (HRSA) over their decision to reject the pharmaceutical company’s rebate model. HHS and HRSA determined that the model was inconsistent with 340B program statutes, and would require approval before the model was implemented. The lawsuit seeks to set aside the rejection, allowing Bristol Myers Squibb to move forward with its discount program. Eli Lilly and Johnson & Johnson have also filed lawsuits regarding the program.

L.A. Care Health Plan Names Martha Santana-Chin as Chief Executive. Health Payer Specialist reported on December 6, 2024, that L.A. Care Health Plan has named Martha Santana-Chin its chief executive, effective January 6. Santana-Chin previously served as plan chief product president for the California market at Centene’s Health Net.

RFP Calendar

HMA News & Events

NEW THIS WEEK ON HMA INFORMATION SERVICES
(Exclusive Access for HMAIS Subscribers):

HMAIS Reports

  • Updated Medicaid Managed Care Procurement Tracking Report
  • Updated Section 1115 Medicaid Demonstration Inventory
  • New Georgia Medicaid Managed Care Award Analysis
  • Updated Arizona State Overview
  • Updated Michigan State Overview
  • Updated Ohio State Overview
  • Updated Pennsylvania State Overview
  • HMA Federal Health Policy Quick Takes

Medicaid Data

Medicaid Enrollment and Financials:

  • Florida Medicaid Managed Care Enrollment is Down 10.9%, Sep-24 Data
  • Georgia Medicaid Managed Care Enrollment is Down 10.6%, 2024 Data
  • Illinois Medicaid Managed Care Enrollment is Down 8.9%, Sep-24 Data
  • Illinois Dual Demo Enrollment is Down 19.6%, Sep-24 Data
  • Mississippi Medicaid Managed Care Enrollment is Up 5.7%, Nov-24 Data
  • Nevada Medicaid Managed Care Enrollment is Down 11.5%, Oct-24 Data
  • Tennessee Medicaid Managed Care Enrollment is Down 13%, Oct-24 Data

Public Documents: 

Medicaid RFPs, RFIs, and Contracts:

  • Georgia Medicaid Care Management RFP, Awards, Scoring, HMA Analysis, and Related Documents, 2023-24
  • Maine IV&V Services for MES Health PAS Modernization Process RFP, Dec-24
  • Michigan Coordinated Health HIDE SNP RFP, Proposals, Awards, Evaluations, and Related Documents, 2024
  • Nevada CO D-SNP RFP and NOIA, 2024
  • Ohio EQRO RFP and Attachments, Dec-24
  • Virginia NEMT Broker Services RFP, Nov-24
  • Vermont NEMT Provider Contract and Amendments, 2021-24

Medicaid Program Reports, Data, and Updates:

  • Idaho Medicaid Dental, IBHP Capitated Rate Certifications, 2025
  • Louisiana Medicaid Managed Care Actuarial Rate Certifications and Data Books, 2018-24
  • Massachusetts MassHealth Section 1115 Waiver Documents, 2021-24
  • Montana HEART Program Section 1115 Demonstration Waiver Documents, 2021-24
  • Nevada Treatment of Opioid Use Disorders and Substance Use Disorders Transformation Project 1115 Waiver Request, 2022-24
  • North Carolina Medicaid Reform Section 1115 Demonstration Waiver Documents, 2017-24
  • South Dakota Department of Social Services Medicaid Annual Reports, 2012-24
  • Texas Telemedicine, Teledentistry, Telehealth, and Home Telemonitoring Services in Medicaid Report, Dec-24
  • Texas All Access Reports on Mental Health, 2022-24
  • Texas Medicaid CHIP Data Analytics Unit Quarterly Reports, 2018-24
  • Texas Medicaid Behavioral Health In Lieu of Services Annual Reports, 2020-24

A subscription to HMA Information Services puts a world of Medicaid information at your fingertips, dramatically simplifying market research for strategic planning in healthcare services. An HMAIS subscription includes:

  • State-by-state overviews and analysis of latest data for enrollment, market share, financial performance, utilization metrics and RFPs
  • Downloadable ready-to-use charts and graphs
  • Excel data packages
  • RFP calendar

If you’re interested in becoming an HMAIS subscriber, contact Andrea Maresca at [email protected].

Edited by:

Alona Nenko
Andrea Maresca
Mary Goddeeris
Gabby Palmieri
Maddie McCarthy
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